It is unconscionable to me that surgeons would jigger the statistics in what is going to be a widely-read paper that PURPORTS to show relatively successful long term results with the VSG, in order to prop up a surgery they obviously want to do - but you have to actually READ THE PAPER to see the most egregious statistical abomination to understand how worthless their data actually is.
This is the recent publication in SOARD - here is the PubMed abstract - the paper is not accessible without a subscription, buying it, or being given access:
Surg Obes Relat Dis. 2014 January - February;10(1):177-183. doi: 10.1016/j.soard.2013.11.007. Epub 2013 Nov 21.
Review of long-term weight loss results after laparoscopic sleeve gastrectomy.
Diamantis T1, Apostolou KG2, Alexandrou A1, Griniatsos J1, Felekouras E1, Tsigris C1.
Author information
Abstract
Sleeve gastrectomy (SG) has gained enormous popularity both as a first-stage procedure in high-risk super-obese patients and as a stand-alone procedure. The objective of this study was to evaluate the long-term weight loss results after SG published in the literature and compare them with the well-documented short-term and mid-term weight loss results. A detailed search in PubMed using the keywords "sleeve gastrectomy" and "long-term results" found 16 studies fulfilling the criteria of this study. A total of 492 patients were analyzed, with a follow-up of at least 5 years after laparoscopic sleeve gastrectomy (LSG) (373 at 5 years, 72 at 6 years, 13 at 7 years, and 34 at 8 or more years). Of the total number of patients, 71.1% were women (15 studies, n = 432 patients). Mean patient age was 45.1 years (15 studies, n = 432 patients). Mean preoperative body mass index in all 16 studies was 49.2 kg/m2. The mean percentage excess weight loss (%EWL) was 62.3%, 53.8%, 43%, and 54.8% at 5, 6, 7, and 8 or more years after LSG, respectively. The overall mean %EWL (defined as the average %EWL at 5 or more years after LSG) was 59.3% (12 studies, n = 377 patients). The overall attrition rate was 31.2% (13 studies). LSG seems to maintain its well-documented weight loss outcome at 5 or more years postoperatively, with the overall mean %EWL at 5 or more years after LSG still remaining>50%. The existing data support the role of LSG in the treatment of morbid obesity.
Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Sounds pretty good, right? But look what's missing from these stats (I have access to the paper, but can't post it - just excerpts):
"Statistical analyses were performed only on the extracted data from the selected studies, in patients who had not undergone another bariatric operation."
And:
"The long-term results after LSG are defined as the results at 5 or more years postoperatively, when LSG is performed without the addition of any other bariatric procedure."
WTF??? How do you purport to be providing data on the LONG-TERM RESULTS of VSG, when you EXCLUDE the failures who had to get a secondary procedure???
This entire paper is therefore WORTHLESS BULLSHIT without this information. They don't even give the number of patients who had another procedure for inadequate weight loss. It could be as much as 20 - 50% which would REALLY change the stats.
Ditto that they didn't report the results as stratified by starting weight or BMI, which would be REALLY useful information - I'll bet those data would show a cut off at about a BMI of 45 for acceptable results for standalone VSG.
Lying liars.
This is the recent publication in SOARD - here is the PubMed abstract - the paper is not accessible without a subscription, buying it, or being given access:
Surg Obes Relat Dis. 2014 January - February;10(1):177-183. doi: 10.1016/j.soard.2013.11.007. Epub 2013 Nov 21.
Review of long-term weight loss results after laparoscopic sleeve gastrectomy.
Diamantis T1, Apostolou KG2, Alexandrou A1, Griniatsos J1, Felekouras E1, Tsigris C1.
Author information
Abstract
Sleeve gastrectomy (SG) has gained enormous popularity both as a first-stage procedure in high-risk super-obese patients and as a stand-alone procedure. The objective of this study was to evaluate the long-term weight loss results after SG published in the literature and compare them with the well-documented short-term and mid-term weight loss results. A detailed search in PubMed using the keywords "sleeve gastrectomy" and "long-term results" found 16 studies fulfilling the criteria of this study. A total of 492 patients were analyzed, with a follow-up of at least 5 years after laparoscopic sleeve gastrectomy (LSG) (373 at 5 years, 72 at 6 years, 13 at 7 years, and 34 at 8 or more years). Of the total number of patients, 71.1% were women (15 studies, n = 432 patients). Mean patient age was 45.1 years (15 studies, n = 432 patients). Mean preoperative body mass index in all 16 studies was 49.2 kg/m2. The mean percentage excess weight loss (%EWL) was 62.3%, 53.8%, 43%, and 54.8% at 5, 6, 7, and 8 or more years after LSG, respectively. The overall mean %EWL (defined as the average %EWL at 5 or more years after LSG) was 59.3% (12 studies, n = 377 patients). The overall attrition rate was 31.2% (13 studies). LSG seems to maintain its well-documented weight loss outcome at 5 or more years postoperatively, with the overall mean %EWL at 5 or more years after LSG still remaining>50%. The existing data support the role of LSG in the treatment of morbid obesity.
Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Sounds pretty good, right? But look what's missing from these stats (I have access to the paper, but can't post it - just excerpts):
"Statistical analyses were performed only on the extracted data from the selected studies, in patients who had not undergone another bariatric operation."
And:
"The long-term results after LSG are defined as the results at 5 or more years postoperatively, when LSG is performed without the addition of any other bariatric procedure."
WTF??? How do you purport to be providing data on the LONG-TERM RESULTS of VSG, when you EXCLUDE the failures who had to get a secondary procedure???
This entire paper is therefore WORTHLESS BULLSHIT without this information. They don't even give the number of patients who had another procedure for inadequate weight loss. It could be as much as 20 - 50% which would REALLY change the stats.
Ditto that they didn't report the results as stratified by starting weight or BMI, which would be REALLY useful information - I'll bet those data would show a cut off at about a BMI of 45 for acceptable results for standalone VSG.
Lying liars.
